Department of Health and Social Care

Genito-urinary medicine

Baroness Merron: To ask His Majesty's Government whether they have assessed demographic data in respect of the move by some sexual health services to offer in-person appointments only to those reporting symptoms of a sexually transmitted infection.

Lord Markham: No assessment has been made of demographic data on provision of sexual health services.Local authorities are responsible for commissioning comprehensive open access to most sexual health services through the public health grant funded at £3.5 billion in 2023/24.  It is for individual local authorities to decide their spending priorities based on an assessment of local need and to commission and evaluate the service lines that best suit their population, including online and in-person provision.

Health Services: Children and Young People

Baroness Merron: To ask His Majesty's Government what steps they are taking to reduce NHS treatment waiting times for children and young people.

Baroness Merron: To ask His Majesty's Government what steps they are taking to reduce backlogs for elective procedures in child health services.

Lord Markham: Cutting National Health Service waiting lists, including for elective child health services, is one of the Government’s top priorities. To support elective recovery, the Government plans to spend more than £8 billion from 2022/23 to 2024/25 to help drive up and protect elective activity. Steps taken include increasing capacity, seeking alternative capacity in other trusts or the independent sector and engaging with patients to understand their choices.We met our target to virtually eliminate long waits of two years or more for elective procedures in July 2022. We also virtually eliminated waits of over 18 months by the end of June 2023, a reduction of over 94% from the peak of 125,000 in September 2021. Our next ambition is to eliminate waits of 65 and 52 weeks.

Cancer: Young People

Lord Hunt of Kings Heath: To ask His Majesty's Government what assessment they have made ofthe campaign by Young Lives vs Cancer to establish afund to help cover the cost of travelling to treatment for young cancer patients.

Lord Markham: The Minister of State for Health and Secondary Care (Will Quince MP) is aware of this campaign and has exchanged correspondence with Young Lives vs Cancer on this matter.The Government recognises that the cost of travel should not be a barrier to treatment. There are schemes, such as the Healthcare Travel Costs Scheme, in place to provide financial assistance for travel to a hospital or other National Health Service premises for specialist NHS treatment or diagnostics tests when referred by a doctor or other primary healthcare professional.

Continuing Care: Finance

Lord Pearson of Rannoch: To ask His Majesty's Government, further to the Written Answer byLord Markham on 24 July (HL9409),whether they intend to make enquiries as to whether personal health budgets are available to all those receiving National Health Service Continuing Healthcare (CHC); and whether integrated care boardsare providing information onpersonal health budgets to all those eligible forCHC, including offering them the option of taking them up, and supporting them to do so.

Lord Markham: The Government have not made an assessment of whether personal health budgets are available to people receiving NHS Continuing Healthcare (CHC) that need them.The Department is responsible for CHC policy and legislation, which includes the National Framework for NHS Continuing Healthcare and National Health Service-funded Nursing Care. Operational delivery of CHC is the responsibility of integrated care boards (ICBs) with oversight from NHS England. Quarterly performance data is used by regional NHS England teams to inform ICB assurance.Legislation requires ICBs to provide people eligible for CHC with information about personal health budgets, to promote their availability and to provide advice and assistance with respect to requesting such budgets.

Clinical Trials: Applications

Lord Blunkett: To ask His Majesty's Government what are the reasons for the variation between 2019 and 2023 in the time takenfor new Clinical Trial Authorisation applications to the Medicines and Healthcare products Regulatory Agency to be assessed.

Lord Markham: A combination of factors has resulted in extended timeframes in Medicines and Healthcare products Regulatory Agency (MHRA) assessment of clinical trial applications and amendments, in particular the loss of experienced staff and the need to recruit and train new staff. The MHRA understands the vital importance to patients and the public as well as researchers and developers of efficient clinical trials approvals, and over the summer it has taken urgent action to address delays to clinical trial approval.Applicants will have seen increased rates of assessment in all key areas, as the MHRA focused considerable resources within the agency to deliver accelerated improvements to timescales for clinical trial assessments. The MHRA has made significant progress and most delayed applications have now been processed.From 31 July to 1 September 2023, the MHRA assessed 1,185 applications for initial clinical trials and amendments. This demonstrates the significant effort that the MHRA has made to address backlogs and move back to assessment in statutory timescales. From 1 September 2023 all newly received fully compliant applications are being assessed within statutory timeframes.

Disability: Mental Illness

The Marquess of Lothian: To ask His Majesty's Government, following the publication of the Inequalities in disability report by the Institute of Fiscal Studies on 23 August, what steps they are taking to address the rise in mental health issues and disability benefit claims among children, and in particular the doubling of the rate of girls aged 16 who are in contact with mental health services since 2017–18.

Lord Markham: We are progressing work with NHS England to increase access to children and young people’s mental health services as outlined in the NHS Long Term Plan. The NHS Long Term Plan commits to increasing investment in mental health services by at least £2.3 billion a year by March 2024 so that an additional 345,000 children and young people are able to get the National Health Service-funded mental health support they need.

Mesothelioma: Research

Baroness Hodgson of Abinger: To ask His Majesty's Government whether they are funding research into finding a cure for mesothelioma.

Lord Markham: Research is crucial in the fight against cancer. That is why the Department invests £1 billion per year in health research through the National Institute for Health and Care Research (NIHR). NIHR research expenditure for all cancers was over £101 million for 2021/22.NIHR funded the following research programmes, totalling approximately £3 million, since 2018: - A double blind, placebo-controlled, randomized phase II study of Pemetrexed and Cisplatin with and without Ruxolitinib in Malignant Pleural Mesothelioma;- Mesothelioma and Radical Surgery 2: a multicentre randomised trial comparing (extended) pleurectomy decortication versus no (extended) pleurectomy decortication for patients with malignant pleural mesothelioma (MARS 2);- Nivolumab with ipilimumab for untreated unresectable malignant pleural mesothelioma [ID1609];- Treating mesothelioma with Intra-pleural Lipoteichoic acid (the TILT Trial): A feasibility study using the ‘Trial within a Cohort’ methodology;- Developing a short-term integrated rehabilitation service for people with newly diagnosed thoracic cancer;- Randomised controlled trial to compare the diagnostic yield of Positron Emission Tomography Computerised Tomography (PET-CT) guided pleural biopsy versus CT-guided pleural biopsy in suspected pleural malignancy (PET-biopsy trial);- Zoledronic acid in the management of malignant pleural mesothelioma - a feasibility study (Zol-A Study); and- MesoTRAP: A feasibility study comparing video-assisted thoracoscopic partial pleurectomy/decortication with indwelling pleural catheter in patients with trapped lung and pleural effusion due to malignant pleural mesothelioma designed to address recruitment and randomisation uncertainties and sample size requirements for a phase III trial. The NIHR is also supporting delivery in the health and care system of over 50 mesothelioma research studies funded by research funding partners in the charity and public sectors since 2018.The NIHR welcomes funding applications for research into any aspect of human health, including research into mesothelioma. As with other Government funders of health research, the NIHR does not allocate funding for specific disease areas. Applications are subject to peer review and judged in open competition, with awards being made based on the importance of the topic to patients and health and care services, value for money and scientific quality.

Coronavirus: Vaccination

Earl Russell: To ask His Majesty's Government what steps they are taking to ensure accurate and timely monitoring of (1) new COVID-19 cases, and (2) new variants of the disease; and when the next round of booster vaccines will be made available to each age group.

Lord Markham: The UK Health Security Agency (UKHSA) conducts routine monitoring and surveillance of COVID-19 and the emergence and spread of new variants internationally via a range of surveillance systems and genomic capabilities. These systems report on infection rates, hospitalisations and the risks posed by new variants. This year’s autumn influenza and COVID-19 vaccine programmes is starting earlier than planned in England, on 11 September 2023, as a precautionary measure. Speeding up the Autumn vaccine programme will deliver greater protection, supporting those at greatest risk of severe illness and reducing the potential impact on the National Health Service.The COVID-19 vaccine will be offered to: - residents in a care home for older adults;- all adults aged 65 years and over;- persons aged six months to 64 years in a clinical risk group;- frontline health and social care workers;- persons aged 12 to 64 years who are household contacts of people with immunosuppression; and- persons aged 16 to 64 years who are carers and staff working in care homes for older adults. An appointment will be offered to eligible people between September and December 2023, with those at highest risk being called in first. Those eligible for vaccination are encouraged to take up the offer of the vaccine as soon as they are called to ensure they head into winter with the best protection.

Health Services: EU Countries

Lord Bourne of Aberystwyth: To ask His Majesty's Government what steps they are taking toencourage the provision of reciprocal free healthcare within Europe and England.

Lord Markham: There is currently wide-ranging advice and guidance on reciprocal healthcare arrangements across GOV.UK, the National Health Service website and the NHS Business Services Authority website. The Department also works closely with the Foreign, Commonwealth and Development Office across Europe to promote people’s reciprocal healthcare entitlements, which includes country-specific guides.We use a variety of communications activities including videos, blogs and social media messaging to reach different groups. The Department also works with travel companies and relevant media outlets to include reciprocal healthcare information.To further promote the benefits of the Global Health Insurance Card, which is the eligibility document for accessing necessary healthcare when United Kingdom residents visit eligible countries, we are in the process of reviewing all Government content to make clearer the benefits of reciprocal healthcare arrangements to the public and ensure people can easily access information on the support available in-country should they require necessary healthcare.

Motor Neurone Disease: Diagnosis

Baroness Ritchie of Downpatrick: To ask His Majesty's Government (1) what is their assessment of the effectiveness of their efforts to enhance early motor neurone disease diagnosis, specifically in terms of reducing diagnostic delays, (2) how they are monitoring and evaluating the effectiveness of their efforts to enhance motor neurone disease diagnosis, and (3) what metrics they are usingto assess progress in this area.

Baroness Ritchie of Downpatrick: To ask His Majesty's Government what measures theyare taking to ensure that healthcare professionals receive updated training and resources for the accurate and timely diagnosis of motor neurone disease.

Lord Markham: All health professionals involved in assessing, caring for and treating people with motor neurone disease (MND) should have sufficient and appropriate training and competence. Individual employers are responsible for ensuring their medical and nursing staff are trained and competent to carry out their role and to invest in the future of their staff through providing continuing professional development (CPD) funding.To supplement local employer investment for CPD, the Government announced in September 2019 a £210 million funding boost to provide every nurse, midwife, and allied health professional (AHP) working in the National Health Service in England with a personal budget of £1,000 over three years to 2022/23.The NHS Long Term Workforce Plan, published on 30 June 2023, sets out NHS England’s commitment to continue national CPD funding for nurses, midwives and AHPs. The operation of this scheme will be kept under review, to ensure subsequent funding is in line with workforce growth and inflation, well-targeted and achieving the desired outcomes.To support the diagnosis of MND, the National Institute for Health and Care Excellence has published a clinical guideline on the assessment and management of MND (NG42).NHS England commissions specialised neurology services for the assessment, diagnosis and care of patients with a range of neurological conditions, including MND, as set out in the published service specification. A copy of this specification is attached.NHS England currently has a National Transformation Programme for Neurosciences, which is undertaking considerable work to review and develop optimal care pathways, including early diagnosis and model of care for patients with a range of neurological conditions, including MND.Additionally, the National Neurosciences Advisory Group, a collaboration of specialist clinicians, allied health professionals and charity representatives, developed a clinical pathway for MND, published in June 2023. A copy of the pathway is attached.The pathway is being used to inform the proposed changes to the neurology service model, which will in turn be used to revise the service specification for neurology.NHS England does not currently monitor or evaluate rates of diagnosis of neurological conditions, including MND, nor does it have metrics in place to assess diagnostic rates.Attachment (pdf, 326.9KB)Attachment (pdf, 2879.3KB)

Drugs: Safety

Baroness Bennett of Manor Castle: To ask His Majesty's Government what assessment they have made of the quality and safety of (1) imported, and (2) home produced generic drugs; and whether they plan to step up testing following the decision of the US military to introduce a new testing programme.

Lord Markham: Before a medicine can be placed onto the market in the United Kingdom, it must first receive approval from the Medicines and Healthcare products Regulatory Agency (MHRA) via the granting of a Marketing Authorisation, commonly known as a product licence. Each medicinal product is assessed for its safety, quality, and efficacy. For a generic medicine, an assessment of whether the medicinal product is equivalent to the proprietary medicine will also be performed.Manufacturers of all medicines, including generics, are required to perform testing for each batch before it is released to market to ensure that it meets the specifications as set out in the product licence. There are currently no plans to amend these testing processes. If the UK product is manufactured in a third country there is an additional requirement for testing after importation i.e., after shipping, but before release to the market. This extra control measure is not a requirement for supply to the market in the United States of America.It should be noted that medicines, including generics, must comply with the same Good Manufacturing Standards which are applicable for domestic and third country manufacturers. The MHRA’s medicines inspectorate conduct inspections to ensure that those manufacturing medicines meet these stringent Good Manufacturing Practice standards. These standards are also applicable to the testing facilities, which are also the subject of inspections to ensure the appropriate standards are being met.

Motor Neurone Disease: Research

Baroness Ritchie of Downpatrick: To ask His Majesty's Government what is their current assessment of coordination of motor neurone disease research via the MND Collaborative Partnership, co-funded by the medical research charity LifeArc and the motor neurone disease patient charities MND Association, My Name’5 Doddie Foundation and MND Scotland.

Lord Markham: The MND Collaborative Partnership is monitored by the funding partners via quarterly reporting. The Partnership was launched to bring researchers together to speed the development of effective treatments for motor neurone disease. The Government, via the Medical Research Council and the National Institute for Health and Care Research, is co-funding the £4.25 million collaborative alongside LifeArc, My Name’5 Doddie, MND Association and MND Scotland. The Government is contributing a further £2 million to focus on gathering and analysing existing data.

Bishop's Castle Community Hospital: Hospital Beds

Lord Rooker: To ask His Majesty's Government why the in-patient beds at Bishop’s Castle Community Hospital in Shropshirehave been closed; and what plans they have to reopen them.

Lord Markham: NHS Shropshire, Telford and Wrekin commissions Shropshire Community Health NHS Trust to provide services in Bishop’s Castle Community Hospital, including inpatient bed facilities. 16 inpatient beds were temporarily closed in October 2021 due to sustained and unacceptable nursing vacancies and concerns about the quality of care and patient safety. In August 2023, the trust commissioned an external review of its recruitment process and on 12 June 2023 began a period of formal engagement with patients, carers, members of the public, stakeholders, clinicians, and staff to inform its final decision on whether to relinquish the contract it holds for the inpatient service. A board meeting was held on 7 September 2023, which considered the details of the reports from all the planned engagement activity. The Board concluded that it cannot be assured the recruitment efforts have been reasonable and sufficient and further recruitment attempts are needed before withdrawing from the inpatient service. The trust will now produce a workforce and recruitment plan and re-attempt recruitment with a view to safely staffing and re-opening the beds.

NHS: Doctors and Nurses

The Lord Bishop of St Albans: To ask His Majesty's Government how many (1) doctors, and (2) nurses, left the NHS in (a) 2019, (b) 2020, (c) 2021, and (d) 2022.

Lord Markham: The table below shows the published data on the leaver rates as a percentage and the number of doctors and nurses & health visitors who have left active service in National Health Service trusts and core organisations, for each annual period 2019 to 2022.PeriodDoctorsNurses & Health Visitors31 December 2018 to 31 December 201917,863 (14.7%)33,188 (10.2%)31 December 2019 to 31 December 202017,045 (13.3%)30,392 (9.0%)31 December 2020 to 31 December 202119,156 (14.4%)36,689 (10.6%)31 December 2021 to 31 December 202221,078 (15.2%)41,121 (11.4%)Source: NHS England Workforce StatisticsThe latest figures published by NHS England for the year to March 2023 show leaver rates are falling, and currently stand at 15.0% for doctors and 10.9% for nurses and health Visitors. Leaver’s data is based on headcount and shows staff leaving active service. This would include those going on maternity leave or career breaks, as well as those leaving NHS trusts and core organisations, including integrated care boards, to work in another part of the health and social care sector, including social care or primary care. The number of doctors leaving includes doctors in training grades, of whom some will be rotating out of NHS trusts to other parts of the health and social care sector as part of planned programmes of training.

Influenza: Vaccination

Baroness Ritchie of Downpatrick: To ask His Majesty's Government what assessment they have made of the benefits of expanding the portion of the flu immunisation programme delivered by community pharmacies.

Lord Markham: National Health Service providers determine how many seasonal flu vaccines to buy each year based on their local populations, eligible cohorts and uptake ambitions for the NHS programme as outlined in the annual flu system letter. The letter, published on 25 May 2023, is based on the advice of the Joint Committee on Vaccination and Immunisation who review the latest evidence on flu vaccines and advise on the type of vaccine to be offered to different age groups and on which vaccines should be prioritised for various at-risk groups.In 2022/23, approximately 9,800 out of a total of around 10,800 community pharmacies delivered flu vaccinations in England. In the same year, approximately 700 community pharmacies piloted using the NHS National Booking Scheme for flu appointments for the first time. In terms of this year’s programme, all community pharmacies delivering COVID-19 vaccinations will be expected to deliver flu vaccines too. All pharmacies will be given the functionality to offer flu appointments via the national booking system with the aim of increasing coadministration of COVID-19 and flu vaccinations.The community pharmacy service is currently an advanced service, which means it is commissioned nationally and any contractor that meets the criteria for the service can deliver it. We do not expect a significant change to be seen to the proportion of seasonal flu vaccination programme being delivered by community pharmacies, which is estimated to be approximately 86% total number of community pharmacies, in 2023/24.In terms of this year’s programme, all community pharmacies delivering COVID-19 vaccinations will be expected to deliver flu vaccines too. All pharmacies will be given the functionality to offer flu appointments via the national booking system with the aim of increasing coadministration of COVID-19 and flu vaccinations.

Health and Technology: Research

Baroness Ritchie of Downpatrick: To ask His Majesty's Government what is the breakdown by department of the current allocation of Government funding for projects aimed at translating health research into practical innovations; what plans they have, if any, to increase such funding; how they plan to support collaborations between academic institutions and industry to expedite the development of healthcare technologies and treatments; and what steps they are taking to ensure that promising research findings are supported for successful translation into practical applications.

Lord Markham: The Department funds and enables research through the National Institute for Health and Care Research (NIHR). In 2022/23, the NIHR budget was approximately £1.25 billion and enabling translation of research into practice is embedded across multiple workstreams in the NIHR portfolio. Its close working with the NHS England Accelerated Access Collaborative also promotes the adoption and diffusion of proven innovations and the decommissioning of ineffective or superseded interventions. The Innovative Licensing and Access Pathway, launched in 2021, also aims to accelerate the time to market by streamlining the regulatory and access processes, particularly for innovative and promising medicines, ensuring that they reach patients more efficiently and rapidly.

Neurology: Research

Baroness Ritchie of Downpatrick: To ask His Majesty's Government what assessment they have made of the scale of the gap in the understanding of neurodegenerative diseases; how this compares to other similarly complex disease areas; and what steps they are taking to support research into the biological causes of dementia.

Lord Markham: Government responsibility for delivering dementia and neurodegeneration research is shared between the Department of Health and Social Care, with research delivered by the National Institute for Health and Care Research (NIHR), and the Department of Science, Innovation and Technology, with research delivered via UK Research and Innovation. The NIHR funds translational, clinical, and applied health and care research.The Government has not assessed the scale of the gap in the understanding of neurodegenerative diseases; and how this compares to other similarly complex disease areas. However, the Government has funded research which looks across neurodegenerative and complex conditions and opportunities to apply learning from research into one condition to another. A recent study undertaken at the Medical Research Council Laboratory of Molecular Biology determined the structures of α-synuclein filaments from the brains of individuals with Parkinson’s disease and dementia with Lewy bodies, which will aid in the development of better diagnostics for Lewy body diseases.The Government supports research into the biological causes of dementia, for example, at the UK Dementia Research Institute, scientists are undertaking ground-breaking research on the biological mechanisms of dementia, driving early-stage development of diagnostics and treatments, and developing innovative technologies for assisted living.

Mesothelioma: Mortality Rates

Baroness Hodgson of Abinger: To ask His Majesty's Government what were the survival rates for people diagnosed of mesothelioma in each of the five years up to December 2022.

Lord Markham: The latest mesothelioma cancer survival statistics available are for those adults diagnosed between 2016-2020, followed up to 2021.The table below provides the year of cancer diagnosis, the years since diagnosis (from 1 to 5), and the respective survival rates, with associated 95% upper and lower confidence intervals (CIs). Where estimates are not possible due to low reliability, a [u] is shown. Year of diagnosisYears since diagnosisNet survival (%)Net survival, lower 95% CINet survival, upper 95% CI2016-2020146.044.747.42015-2019146.044.847.32014-2018145.344.046.72013-2017144.743.546.02012-2016144.543.245.72016-2020224.123.025.22015-2019223.622.524.72014-2018223.122.024.12013-2017221.720.722.82012-2016221.420.422.42016-2020314.713.815.72015-2019314.313.415.22014-2018313.812.914.72013-2017312.812.013.72012-2016312.211.413.12016-2020410.09.110.92015-201949.68.710.52014-201849.48.610.32013-201748.37.49.22012-201647.66.88.52016-20205[u][u][u]2015-201957.16.282014-201857.16.38.12013-201756.65.87.62012-20165[u][u][u] This information is provided as survival estimates in rolling five-year periods because there are insufficient diagnoses of mesothelioma to provide estimates by a single year of diagnosis. This is because of the statistical frameworks used in the estimation of survival analysis which require minimum numbers of patients to be alive at each estimation point and for a minimum number to have died around the same time to reliably estimate the mortality rates of the cancer cohort. For cancers like mesothelioma, the number of patients remaining alive quickly falls to a number that no longer permits the estimation of survival beyond 5-years after diagnosis, shown as [u] in the table to detonate low reliability.   Furthermore, all estimates of survival vary with time from diagnosis. We have provided estimates at one, two, three, four and five years after diagnosis for five periods of diagnosis: 2012-2016 to 2016-2020, which is the most recent available.

Influenza: Vaccination

Baroness Ritchie of Downpatrick: To ask His Majesty's Government under what circumstances they would consider reintroducing the 50-to-64-year-old age cohort into the flu vaccine programme, as was the case during the COVID-19 pandemic.

Lord Markham: The Government’s policy on groups eligible for flu vaccination is based on the recommendation of the independent expert body the Joint Committee on Vaccination and Immunisation (JCVI).During the COVID-19 pandemic, the JCVI was supportive of the temporary expansion of the influenza programme to extend eligibility to all adults aged between 50 and 64 years of age to protect the population from the potential threat of co-circulation of COVID-19 and flu and alleviate pressure on the National Health Service. This was the policy for both the 2020 to 2021 and 2021 to 2022 seasons.The success of the COVID-19 vaccination programme and a better understanding of SARS-CoV-2 infection means that we are now able to return eligibility for the flu vaccination programme back to the approach taken pre-pandemic.

Department for Transport

Railway Stations: Tickets

Lord Patten: To ask His Majesty's Government whether they plan to publish the results of the public consultations on proposals to close manned ticket offices at railway stations in England; and if not, why they do not plan to publish.

Baroness Vere of Norbiton: This is an industry led process where Train Operating Companies put forward proposals to close or change the opening hours of station ticket offices and launch passenger consultations. The independent passenger bodies, Transport Focus and London TravelWatch, are currently considering the consultation responses and will publish their response to each train operator’s proposals once the process has completed.

Hammersmith Bridge

Baroness Hodgson of Abinger: To ask His Majesty's Government when they expect Hammersmith Bridge to reopen to traffic.

Baroness Vere of Norbiton: Transport in London is devolved. Hammersmith Bridge is owned by the London Borough of Hammersmith and Fulham (LBHF) which is responsible for its repair and maintenance. Stabilisation works are underway; a business case for strengthening works is in development. Providing a schedule for the full reopening of the bridge is part of the business case development process.

Department for Work and Pensions

Social Security Benefits: Artificial Intelligence

Lord Taylor of Warwick: To ask His Majesty's Government what steps they are taking to improve the response to requests for transparency over the use of artificial intelligence to verify welfare claims.

Viscount Younger of Leckie: DWP recognises the public interest in being transparent about what we do and how we process personal information. However, we have to balance this with keeping the information secure, by not revealing publicly all methods and practices used particularly to detect fraudulent claims and cyber-attack against our systems. DWP takes its responsibility to protect data very seriously and we have published the Personal information charter (PIC) which gives details of how we use information provided to us. We have done this to be as transparent as we can without hindering our ability to detect fraud and protect data. The PIC also explains that DWP does not use artificial intelligence to replace human judgement to determine or deny a payment to a claimant. We will only use data for lawful purposes. The DWP annual report and accounts 2022 to 2023 - GOV.UK (www.gov.uk) also makes mention of audits covering data management and artificial intelligence.

Treasury

National Insurance: Profits

Lord Sikka: To ask His Majesty's Government what assessment they have made of the revenues which could be raised by levying national insurance upon chargeable capital gains.

Baroness Penn: National Insurance contributions (NICs) are part of the UK’s social security system. The system, based around the longstanding contributory principle, is centred around paid employment and self-employment, with employers, employees and the self-employed paying into the National Insurance Fund and providing funding for the NHS. Payment of NICs builds an individual’s entitlement to claim contributory benefits which then replace earnings in certain circumstances, for example if someone is unable to work or is retired. Non-employment income is generally excluded from liability to NICs as it is not derived from paid employment. Consequently, individuals with only non-employment income need to pay voluntary NICs in order to build entitlement. The Government keeps all taxes under review.

Self-employed: National Insurance

The Earl of Clancarty: To ask His Majesty's Government whether they have any plans to fully digitise the processing of A1(CA3837) documents for UK self-employed workers in the music industry temporarily working in Europe, including the issuing of such documents.

Baroness Penn: In response to customer feedback, HMRC introduced a new online version of the form CA3837 in June 2023, which was designed to streamline the application process, offering a number of enhancements and providing additional guidance for more complex questions. HMRC intend to automate the CA3837 application process in the Autumn which will improve processing times and remove opportunities for error.

Housing Improvement: VAT

Baroness McIntosh of Pickering: To ask His Majesty's Government what assessment they have made of any distortion to the housing market caused by VAT on the renovation and restoration of existing homes as opposed to VAT exemption for the building of new homes; and what plans they have, if any, to address such distortion.

Baroness Penn: The construction of certain new-build properties, including residential buildings, is subject to a VAT zero rate to encourage the construction of new homes. A reduced rate of VAT at five per cent is also maintained, subject to certain conditions, for residential renovations. This includes conversions of buildings from one residential use to another, conversions from commercial to residential use, and the renovation of properties that have been empty for two years or more. Extending this VAT relief would impose additional pressure on the public finances to which VAT makes a significant contribution. As such, the Government has no plans to introduce a VAT relief on the renovation and restoration of existing homes; however, the Government keeps all taxes under review.A temporary zero rate (up to April 2027) also applies to installations of qualifying energy saving materials, such as insulation, solar panels and heat pumps into residential accommodation. This relief is targeted at materials that specifically improve the energy efficiency or reduce carbon emission from a residential property.

Self-employed: National Insurance

The Earl of Clancarty: To ask His Majesty's Government whether they have any plans to replace all single-use A1 (CA3837) documents for UK self-employed workers in the music industry with an A1 document valid for two years covering multiple unspecified (1) tours, (2) countries, and (3) dates.

Baroness Penn: HMRC issues A1 certificates where a self-employed individual is subject to UK social security legislation whilst working in the EU. The rules for issuing certificates apply equally to HMRC and EU Member State social security authorities. The government has no plans to seek changes at this time.

Business Rates

Lord Taylor of Warwick: To ask His Majesty's Government what plans they have to reduce the business rate multiplier in England and Wales.

Baroness Penn: At the Autumn Statement 2022, the Government announced a freeze to the business rates multiplier for 2023-24, a tax cut worth £9.3 billion over the next five years. This was the third consecutive year the multiplier has been frozen, protecting businesses from inflationary pressures at an overall cost of £14.5 billion. Business rates are an essential form of funding for local government to provide vital public services. The Government keeps all taxes under review.

Self-employed: National Insurance

The Earl of Clancarty: To ask His Majesty's Government what is the average time between the (1) application for, and (2) issuing of, an A1 (CA3837) document for UK self-employed workers; and whether they have any plans to reduce the processing time for such applications.

Baroness Penn: The average time it is taking HMRC to process/issue A1s received online is 15 weeks as it stands today. HMRC processes 3 different applications forms (CA3822, CA3837 and CA8421) that can result in A1s being issued.It is not possible to break it down to average processing times for each application due to the complexities of HMRC’s internal digital mail systems.In quarter 3, HMRC plans to upskill additional colleagues to help process the backlog of CA3822s and this will include CA3837s and CA8421s which will help to reduce processing times.HMRC intend to automate the CA3837 application process in the Autumn which will improve processing times and remove opportunities for error.

Capital Gains Tax

Lord Sikka: To ask His Majesty's Government what assessment they have made of the tax revenues which could be raised by aligning the capital gains tax rates with those applied to wages and salaries.

Baroness Penn: As set out in the Government’s response to the Office of Tax Simplification's report on Capital Gains Tax (CGT) on 30 November 2021, substantial reforms to CGT rates and allowances would involve a number of wider policy trade-offs and so careful thought must be given to the impact that they would have on taxpayers, as well as any additional administrative burden on HMRC. The Government will continue to keep the tax system under review to ensure it is simple and efficient.